The Affordable Care Act on Trial

By Maureen Shawn Kennedy, MA, RN, editor-in-chief

According to the National Conference of State Legislatures, 47 states have enacted some legislation to block or limit various requirements of the Affordable Care Act (ACA). And a week from Monday, on March 26, the Supreme Court will begin hearings on the constitutionality of the law, as 26 states bring suit against the federal government. The primary issue for the Court: can the federal government mandate that individuals must purchase health insurance?

Other closely related issues the court has also set aside time to consider are whether other provisions of the law can still be implemented or must be voided if the individual mandate is struck down, the legality of the proposed Medicaid expansion, and whether the court must in fact wait until the individual mandate is actually implemented in 2015 before even considering its legality.

So how do many Americans feel? The Kaiser Family Foundation has been tracking opinions on the law and offers an excellent interactive chart that shows opinions according to different variables, including age, income, political party affiliation, gender, and current insurance status. Their findings may surprise you.

For more information about the Affordable Care Act and it implications for nursing, here are some links to AJN’s coverage since it was signed into law in 2010:

“Nurses and the Affordable Care Act,” Mary Wakefield
“What Future for the Affordable Care Act,” Diana Mason
“Health Care Reform and a System […]

2016-11-21T13:10:29-05:00March 16th, 2012|health care policy|0 Comments
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When Lawmakers and Physicians Hold Nurses Back

Editor’s Note: Toni Inglis, MSN, RN, CNS, FAAN, writes opinion for the Austin (TX) American-Statesman. She works at the Seton Healthcare Family in Austin as a neonatal ICU staff nurse and also writes a nursing blog for Seton and edits its monthly NursingNews. This article is a reprint of an April 22nd commentary in the Statesman. Toni was inspired to write the column after a particularly disappointing legislative session, in which Texas advanced practice nurses made fewer gains than in past sessions—despite Texas ranking last in access to health care and having the most restrictive laws in the country regarding APRN scope of practice and prescriptive authority. She believes the poor access and barriers to practice are related.

AJN finds the article particularly relevant as legislatures across the country deliberate on APRN barriers to practice. You can read her commentaries at ingliscommentary.com.

Here’s an idea that wouldn’t cost Texas a dime but would save millions of dollars every year: Remove all barriers restraining nurses from practicing to the full extent of their education and training.

No state needs primary care providers more than Texas, which has a severe shortage. Texas ranks last in access to health care and in the percentage of residents without health insurance. Of Texas’ 254 counties, […]

2016-11-21T13:10:43-05:00February 13th, 2012|health care policy, nursing perspective|0 Comments
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Year-End Take: A Hopeful Trend in U.S. Health Care?

Less Is Sometimes More
A hopeful trend that’s gained some serious momentum this year—and may be connected to both the recession and some provisions of the Affordable Care Act—is that we’re beginning to question whether we really need quite so many tests and drugs. By ‘we’ I mean researchers, some journalists, some nurses and physicians, and of course patients. The answers aren’t always clear, and there’s plenty of room for disagreement on many such issues, but at least we’re asking the right questions more often, rather than retreating in fear and simply hurling around the word “rationing”:

Who really benefits from prostate and breast cancer screening and who is more likely to be harmed, and why? When are you too young or too old to be likely to benefit from a certain type of screening? When does aggressive care at the end of life cease to make sense? Are we confusing a risk factor with a disease, an association with causation, relative risk with absolute risk?

Does that drug you see relentlessly marketed in advertisements during breaks in the network news actually help you? Which physicians are being paid as consultants in support of various drugs, tests, or treatments, and does this compromise their objectivity? And so on. The latest example of this kind of analysis I’ve stumbled across can be found here: “Disease Creep: How We’re Fooled Into Using More Medicine Than We Need.”

The Many Faces of Nursing
So, that’s […]

2016-11-21T13:11:06-05:00December 27th, 2011|health care policy, nursing perspective|3 Comments
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Changes in Latitude: Comparing Health Care Systems with Nurses Down Under

By Peggy McDaniel, BSN, RN, who writes the occasional post for this blog and currently works as a clinical liaison support manager of infusion in Australia, New Zealand, and Asia Pacific.

I recently found myself sitting on a boat, enjoying a “sausage sizzle,” dressed as a pirate no less. In Australia, a party that includes barbecued meat usually includes sausage; thus the name. The pirate theme was an added bonus. As an American and a nurse, I was pleasantly surprised to find myself seated at the same table as two Australian nurses. What were the chances of that? The conversation that evening gave me some insight into the Australian health care system, which I am just getting familiar with.

Comparing health care systems. Once we all realized we were experienced nurses and shared the belief that quality patient care should always be the primary focus of health care, the conversation turned to cost. In Australia, there is a public health option that all Australians can access. It is paid for by taxes. If you choose to do so, you can also purchase a private plan to supplement this public option. I have yet to determine what part, if any, employers play in paying for health care or private insurance. However, a sick Australian […]

2016-11-21T13:11:39-05:00October 26th, 2011|health care policy, nursing perspective|43 Comments
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Federal Budget Battles Begin – Health Professions Education at Stake

By Shawn Kennedy, MA, RN, AJN editor-in-chief

I’m subscribed to many listservs, mailing lists, and eNews alerts that help me keep track of news that may be important to nurses. One e-mail list I’m on is the Health Professions and Nursing Education Coalition (HPNEC), from the Association of American Medical Colleges. It closely monitors funding for health professions education.

Last week, the e-mail reported on the proposed 2012 federal budget—that is, the initial draft proposed by the House Labor, Health and Human Services, and Education departments appropriations subcommittee. Among a great deal else, this includes funding for  Medicare, the National Institutes of Health, the CDC, and medical and nursing education (Title VII and Title VIII funding).

There’s already contention over the proposal, with the Democrats claiming they had nothing to do with it. According to ranking Democratic member Rep. Norm Dick, quoted in the minority party press release: “Make no mistake: this is not a committee product. This draft bill represents the ideological position of one committee member—the subcommittee chairman.”

Among other aspects, the proposal includes cuts to all monies to Planned Parenthood (as long as it continues to provide abortion services), National Public Radio, and any programs under the Affordable Health Care for America Act.

According to the HPNEC e-mail: “The bill offers a total of $87.5 million for Title VII programs, a $185 million (67.9 percent) cut, by eliminating funding for the Title VII Health Careers Opportunity Program, scholarships for disadvantaged students, primary care medicine, Area […]

2016-11-21T13:11:49-05:00October 3rd, 2011|health care policy, nursing perspective, students|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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